Core I: International ABSTRACT The International Core (Core I) is focused on developing clinical and patient-oriented adult and pediatric HIV/AIDS research and research capacity in Botswana, a country in southern Africa with one of the world's highest rates of HIV infection, but with excellent infrastructure and strong commitment to advancing AIDS clinical programs for its population and promoting HIV-related research and research capacity. The Core's missions are to nucleate new collaborations among Penn and Botswana-based investigators and provide infrastructure for studies implemented in Botswana that will advance high priority research relevant to the country, and to train the next generation of US- and Botswana-based HIV/AIDS investigators. The Core's focus remains cutting edge by maintaining close relationships and conducting strategic planning with Botswana-based stakeholders including the University of Botswana (UB) & Ministry of Health and Wellness, and working closely with other CFAR cores for synergy. Core I is led by Drs. Robert Gross (Director, based at Penn) and Tonya Arscott-Mills (Co-Director, in Botswana), along with Core Investigators Drs. Andrew Steenhoff (at CHOP) and Billy Tsima (at UB); Dr. Tsima joined Core I this year after receiving his MSCE in a Core I training program and appointment to the UB faculty. Operations are facilitated by the facts that both Drs. Arscott-Mills & Tsima are based in Botswana, English is an official language, and Core I leverages resources of the institutionally-funded Botswana-UPenn Partnership. Core research services include (1) consulting on feasibility and local appeal of research ideas targeting issues and populations in Botswana; (2) engaging key stakeholders and local collaborators to ensure optimal design and efficient implementation of projects; (3) support for protocols including assistance with IRB submissions and translation of materials into the local language (Setswana) to allow for full local participation; (4) hiring, training and supervising local research staff; (5) specimen processing and laboratory analyses or shipping; and (6) secure data management. Core training activities include mentoring of junior investigators from Penn and Botswana who are developing HIV-related research in Botswana; partnering with new-to-HIV and/or new-to- Botswana established investigators; sponsoring seminar at UB and at Penn to disseminate findings & engage investigators; teaching epidemiology & biostatistics skills to aspiring researchers from the US and Botswana; and teaching laboratory skills including hands-on experimental work at Core in-country laboratories. In the current reporting period Core I enabled high priority research on HIV acquisition & treatment; opportunistic infection diagnosis, transmission, treatment and outcomes (particularly TB & cryptococcosis); the intersection of severe mental illness and HIV; HIV in children, adolescents and women; and cervical cancer. Looking ahead, planned innovations include establishing a local Community Advisory Board (CAB); implementing a new project database to more efficiently manage resources; and catalyzing research on key local priorities including advancing interventions for prevention in HIV-negative and reducing comorbidities in HIV-infected individuals.